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Hepatofugal portal venous flow on Doppler sonography after liver transplantation: analysis of presumed causes based on radiologic and pathologic features.
MedLine Citation:
PMID:  22733856     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objectives- The purpose of this study was to categorize hepatofugal portal venous flow on Doppler sonography after liver transplantation and to investigate its clinical importance and presumed causes based on radiologic and pathologic findings. Methods- This retrospective study was approved by our Institutional Review Board, and the requirement for informed consent was waived. Examination of our database over 4 years revealed 30 patients in whom Doppler sonography showed hepatofugal portal venous flow during follow-up periods. We investigated its occurrence and clinical features, including radiologic and pathologic findings, and classified the possible causes into 5 types: A, systemic problems; B, gross vascular abnormalities correctable by intervention; C, specific cardiac problems; D, microscopic abnormalities of the graft; and E, miscellaneous. We classified the patterns of hepatofugal portal venous flow into continuous hepatofugal or hepatofugal-dominant to-and-fro flow and hepatopetal-dominant to-and-fro flow, and we investigated the relationship of the presumed causes and flow patterns with the clinical course. Results- The incidence of hepatofugal portal venous flow was 2.38%. The overall mortality rate was 26.67% (95% confidence interval, 11.1%-42.9%): all patients (n = 5) in group A, 1 in group C, and 2 in group D, died. Possible cause type B and a mainly hepatopetal flow pattern were good prognostic factors (P = .031 and .018, respectively). Conclusions- Hepatofugal portal venous flow reflects diverse pathologic conditions after liver transplantation, and its clinical importance also differs depending on the cause.
Authors:
Woo Kyoung Jeong; Kyoung Won Kim; So Jung Lee; Yong Moon Shin; Jinoo Kim; Gi Won Song; Shin Hwang; Sung-Gyu Lee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  31     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1069-79     Citation Subset:  IM    
Affiliation:
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-2 Dong, Songpa-ku, Seoul 138-736, Korea. kimkw@amc.seoul.kr.
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